Xiao Y, Zhao J, Wu H, Xie KL, Wan Y, Xu XW, Zhang YG. Surgical treatment of malignant biliary papillomatosis invading adjacent organs: A case report. World J Clin Cases 2019; 7(2): 253-259 [PMID: 30705903 DOI: 10.12998/wjcc.v7.i2.253]
Corresponding Author of This Article
Yan-Ge Zhang, MD, Associate Professor, Department of Plastic and Burn Surgery, West China Hospital of Sichuan University, No. 37, Guoxue Lane, Wuhou District, Chengdu 610041, Sichuan Province, China. 58131972@qq.com
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jan 26, 2019; 7(2): 253-259 Published online Jan 26, 2019. doi: 10.12998/wjcc.v7.i2.253
Surgical treatment of malignant biliary papillomatosis invading adjacent organs: A case report
Yang Xiao, Juan Zhao, Hong Wu, Kun-Lin Xie, Ying Wan, Xue-Wen Xu, Yan-Ge Zhang
Yang Xiao, Juan Zhao, Xue-Wen Xu, Yan-Ge Zhang, Department of Plastic and Burn Surgery, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Hong Wu, Kun-lin Xie, Department of Liver Surgery/Liver Transplantation, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Ying Wan, Department of Pathology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Zhang YG, Xiao Y, Wu H, and Xu XW performed the operation; Xiao Y collected the case data and drafted the article; Zhao J and Xie KL consulted literature material and made critical revisions; Wan Y provided pathological pictures; Xiao Y and Zhang YG approved the final version of the article to be published.
Supported byNational Natural Science Foundation of China, No. 81872004.
Informed consent statement: Consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yan-Ge Zhang, MD, Associate Professor, Department of Plastic and Burn Surgery, West China Hospital of Sichuan University, No. 37, Guoxue Lane, Wuhou District, Chengdu 610041, Sichuan Province, China. 58131972@qq.com
Telephone: +86-28-85423421 Fax: +86-28-85423421
Received: October 29, 2018 Peer-review started: October 29, 2018 First decision: November 15, 2018 Revised: December 19, 2018 Accepted: December 29, 2018 Article in press: December 30, 2018 Published online: January 26, 2019 Processing time: 89 Days and 23.5 Hours
Abstract
BACKGROUND
Biliary papillomatosis (BP) is a rare disease characterized by multiple papillary adenomas in the intrahepatic and extrahepatic biliary tree and has a high risk of malignant transformation. Early diagnosis and treatment for BP are challenges, as it spreads along the biliary tract. A radical resection with an adequate resection margin is advocated in patients with malignant BP.
CASE SUMMARY
We report a case of BP with malignant transformation in a 52-year-old female patient who presented with emaciation, severe malnutrition, and a T-tube for biliary drainage that was placed for almost 2 years at the time she visited us. The enhanced magnetic resonance imaging of the upper abdomen revealed a neoplasm with a diameter of 15 cm located in the gallbladder area surrounding the common bile duct where a drainage tube was placed. It was the first case with malignant BP involving multiple organs and the abdominal wall and receiving a radical resection. Plastic surgeons helped close the incision by transferring the rectus muscle and external oblique muscle flap. A diagnosis of papillary carcinoma with diffuse malignant papillomatosis of the biliary duct was given. The postoperative course was uneventful and she was asymptomatic and in good physical condition at 35 mo postoperatively with appropriate chemotherapy.
CONCLUSION
Aggressive surgical treatment with appropriate chemotherapy is advocated for patients with malignant BP even if multiple organ invasion is present.
Core tip: Biliary papillomatosis (BP) is a rare benign tumour with a high risk of malignant transformation. Here, we report a case with malignant BP involving multiple organs and the abdominal wall and receiving a radical resection.
